尿微量蛋白测定在糖尿病肾病早期诊断及病情进展中的应用  

The application of urinary micro-protein detection in early diagnosis and progression of diabetic nephropathy

作　　者：陈文思[1] 林美玲[1] 陈忠诚[1] 胡波[1] 

机构地区：[1]中山大学附属第三医院检验科,广州510630

出　　处：《江西医学检验》2006年第4期301-302,305,共3页Jiangxi Journal of Medical Laboratory Sciences

摘　　要：目的探讨尿微量白蛋白(Micro-Albumin,mALB),转铁蛋白(Transferrin,TRF),免疫球蛋白G(ImmunoglobulinG,IgG),β2微球蛋白(β2-Microglobulin,β2-MG)的检测在糖尿病肾病早期诊断及病情进展中的应用价值。方法把91例糖尿病患者分为尿蛋白阴性、尿蛋白+、尿蛋白++、尿蛋白+++、尿蛋白++++共5组,采用免疫散射比浊法测定5组病人尿的mALB,TRF,IgG及β2-MG含量,并与正常对照组比较。结果糖尿病患者尿蛋白阴性时,尿微量蛋白高于正常对照组,尿蛋白定性阳性时,上述指标随着尿蛋白阳性程度的增加而增高。当尿蛋白定性呈阴性结果时,病人主要呈现中、小分子量的微量蛋白升高;随着病情进展,出现大分子量微量蛋白的病例数也逐渐增多。结论四项指标联合检测更有助于提高糖尿病肾病的早期检出率以及确切判断其病变的部位和损伤程度,对糖尿病肾病的防治具有重要的临床应用价值。Objective To study the clinical value of determination of micro-albumin （mALB）, transferrin （TRF）, immunoglobulin G,（IgG） and β2-Microglobulin（β2-MG） in early diagnosis and progression of diabetic nephropathy. Methods 91 cases of diabetic patients were divided into 5 groups which included negative urine protein, positive urine protein （urine protein＋ ～ ＋＋＋＋）. The urine micro-protein were measured by immunonephelometry and the data were compared with control group. Results DM patients had a higher urinary micro-protein than that of normal people when qualitative tests of urine protein were negative. The levels of every index elevated with the increase of positive urine protein, middle and small molecular Micro-protein increased in most of the patients when qualitative tests of urine protein were negafive. The cases possesed large molecular micro-protein became more and more with the improvement of illness. Conclusions The united determination of urinary mALB, TRF, IgG and β2-MG is be helpful to improve positive rate of diabetic mellitus and estimate the part of illness and degree of injury accurately. There are important clinical value for the index to precaution and treatment of diabetic mellitus.

关 键 词：糖尿病肾病 尿微量蛋白 微量白蛋白 转铁蛋白 免疫球蛋白G Β2微球蛋白 

分 类 号：R446.122[医药卫生—诊断学] R587.1[医药卫生—临床医学]